Study On The Evaluation System Of First-aid Capacity In Tertiary General Hospitals In Shanghai

Objective:Based on the framework of structure-process-result theory model,through literature research,personal in-depth interviews and expert group interviews,the evaluation index of first-aid capacity of tertiary general hospitals was preliminarily constructed and consultation questionnaires were designed.Delphi expert consultation method was used to conduct two rounds of online questionnaire consultation for emergency department staff of eight general hospitals in the city.In the end,the theoretical evaluation index system of the first-aid capacity of the tertiary general hospitals is constructed.Methods: Through literature review,field research and expert group interviews,the basic framework and questionnaire of first-aid capacity evaluation index system based on structure-process-outcome approach theory are preliminarily constructed.Delphi expert consultation method is used for two rounds of questionnaire consultation,and normalization method is used to establish the weight of indicators at all levels.The concrete evaluation index system of first-aid capacity of three-level general hospitals is constructed.Finally,TOPSIS method was used to evaluate the first-aid capacity of sample hospital.Results:The effective rate of the questionnaire was 96.3% and 88.46% respectively,and the authoritative coefficient of experts was 0.78 in both rounds.Finally,three first-level indicators,such as structural indicators,process indicators and outcome indicators,human resources allocation,material resources allocation,service volume,rescue capacity,emergency response capacity,and rescue quality,are formed,including six second-level indicators and 31 third-level indicators.After the application of the evaluation system to the data of the first-aid capacity of a tertiary general hospital from 2016 to 2018.It is concluded that the three-year data evaluation ranking of a tertiary general hospital is 3,2,1,and the first-aid capacity is improved year by year.Solution:(1)Formulate the city's hospital emergency medical resources allocation plan,improve the distribution of hospital emergency medical resources.(2)Guarantee the investment of hospital first-aid resources and the standard construction of emergency departments.(3)To implement graded treatment of emergency patients and within and outside hospital shunts to ensure orderly entrance and exit.(4)Strengthen the integration of emergency and ICU,optimize the rescue process of critical patients and improve the quality of medical treatment.(5)Strengthen the management of key diseases and promote emergency treatment.(6)Promoting the construction of emergency informatization to improve efficiency and quality.(7)Improving the reimbursement policy for medical insurance emergencies and promoting the construction of two-way referral for patients.(8)Cooperate with the advancement of medical reform,guide patients to distribute rationally through price and payment policies.(9)Explore the evaluation system suitable for emergency discipline and team building,performance allocation and work promotion.